This is somewhat old news but these two articles are worth linking here and linking together for they convey nicely, in the words of AC/DC, how “money talks” and also how numbers can talk about how money talks.

I am not so much a researcher of numbers in so far as I don’t produce them, and think it is a good idea to cultivate a healthy skepticism of them, but I do appreciate what they can tell us. I think the article in the NYTimes is particularly insightful because it is based on “public reports of all drug company marketing payments to doctors” in the state of Minnesota, the *only* state that requires this access. The authors of the article are careful to hedge and qualify their findings, but many of them do suggest that the more money a doctor gets, the higher the likelihood they will prescribe more meds and of a certain class. Hopefully more states will pass such legislation and more research will be done.

This is my favorite quote from the article

“There’s an irony that psychiatrists ask patients to have insights into themselves, but we don’t connect the wires in our own lives about how money is affecting our profession and putting our patients at risk,” he said.”

It is sort of stunning in that empowering and disempowering way. The show discusses protests launched again the large pharmaceutical company Abbot who in reaction–no, make that retaliation–to Thailand’s decision to issue compulsory licenses on AIDS drugs, and import generic drugs acted in highly questionable ways:

“Abbott responded in a way that shocked many AIDS activists – the company announced it would withhold seven new drugs from sale in Thailand including a new AIDS drugs and treatments for arthritis and high blood pressure.”

It is great to see countries use the very slim rights granted to them by organizations like the WTO but in order for the rights to have any punch, these countries *must* be given the space to make these decisions without the deep intimation and that is exactly what Abbot is up to.

To learn more, read the transcript, listen to the show. And if you want to go on, I have pasted the “favorite” part of the show:

Are psychiatry and big pharma joined at the hips ? And if yes is this a bad thing?

In a recent speech, the new president of the APA sees the relationship as a little too cozy for comfort: “We have allowed ourselves to be corrupted in this marketplace with lucrative consulting to industry, speaker panels, boards of directors, and visits from industry representatives bearing gifts.”

Some industry representatives and psychiatrists were not moved and responded with their assessment statement:

Unless another model is proposed and shown to be effective, we believe that the strong partnerships and collective contributions of academic, clinical, and industry-employed psychiatrists and neuroscience researchers can best maximize our potential to deliver the highest quality of psychiatric care to all who suffer from mental illness.

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It is nice to see the debate occuring within the field itself and I hope that it continues, especially with some hashing out of other models. And here is one of the most interesting ones in that it takes physical activity and cultural expectations quite seriously.

It now looks like (and I knew this would happen, it was just a matter of time) that state prosecutors are turning up the heat. Zyprexa is a priceeeeeeeeey drug, truly expensive, and since a lot of folks given the drug are on disability or medicaid, the state has been picking up the tab, so a few states, like Illinois and Vermont may be launching civil and criminal investigations, in part to recup their money.